Faculty perceptions and use of e-learning resources for medical education and future predictions / 한국의학교육

Purpose@#This study aims to investigate medical faculties’ perceptions and current practice of using e-learning resources, needs and suggestions for more effective use of such resources, and future directions of e-learning in medical education. @*Methods@#This descriptive study was conducted on full-time faculty members who were registered users of the e-learning portal of the consortium of Korean medical schools. Participants were invited to an online survey containing 45 items that addressed their perceptions and use of e-learning resources, and their predictions of future use. Descriptive analysis and reliability analysis were conducted as well as a thematic analysis of qualitative data. @*Results@#Ninety faculty members from 31 medical schools returned the questionnaires. Participants positively perceived e-learning resources and that they predicted their use would become increasingly popular. Still, only half of the respondents were using e-learning resources for teaching and agreed that they were willing to share their e-learning resources. Our study illustrates several barriers inhibit faculty use and sharing of e-learning resources, and a need for a more comprehensive, better-organized resource repository. Participants also pointed out the needs for more resources on multimedia assessment items, clinical videos, and virtual patients. @*Conclusion@#Our study sheds light on medical faculty needs for institutional support and faculty development programs on e-learning, and institutional policies that address faculty concerns regarding ownership, intellectual property rights, and so forth on creating and sharing such resources. Collaborations among medical schools are suggested for creating a better organized around learning outcomes and more comprehensive repository of resources.

The efficacy of peer assessment in objective structured clinical examinations for formative feedback: a preliminary study / 한국의학교육

Purpose@#We sought to determine the impact of medical students’ prior experience of assessing peers in the objective structured clinical examination (OSCE) on their clinical performance. @*Methods@#Forty-two year 4 medical students participated in an OSCE comprised of three 10-minute stations (syncope, hemoptysis, and back pain). Each student took part in two iterations of the three‐station OSCE as either the examiner or examinee, and student performance was assessed using a checklist by a medical faculty member and a student simultaneously. Students were randomly assigned to two groups and their OSCE scores were compared. Students in the control group were tested at a station first and then participated at the same station as a peer examiner, and those in the intervention group participated as a peer examiner first and then as an examinee. Moreover, student OSCE scores rated by peer examiners were compared with those awarded by faculty to evaluate the accuracy of peer assessment. Following the test, students completed surveys on their perceptions of the usefulness of this formative OSCE. @*Results@#Student overall OSCE scores did not differ between groups. Students in the study group performed better at the hemoptysis station (p<0.001), but poorer at the syncope station (p<0.01). Student performances at the back-pain station were similar in these two groups (p=0.48). OSCE scores rated by faculty and peer examiners were moderately negatively associated at the hemoptysis station (p<0.05), but no such association was observed at the other two stations. This trend was similar in peer examiners who were high-achievers and low-achievers in OSCEs. Students showed positive perceptions of their experience with this OSCE. @*Conclusion@#Student experience as peer assessor offers a feasible means of providing them greater access to OSCEs without consuming more resources, although its impact on enhancing performance in the OSCE is likely to differ across stations.

Development of e-learning in medical education: 10 years’ experience of Korean medical schools / 한국의학교육

PURPOSE: We aimed to explore medical students’ online learning patterns and needs by analyzing data obtained from an e-learning portal of Korean medical schools. METHODS: Data were obtained from learning resources and registered users of the e-learning portal by the consortium of 36 Korean medical schools, e-MedEdu (www.mededu.or.kr) over a period of 10 years. Data analytics were performed of its contents and usage patterns using descriptive statistics. RESULTS: The website currently has over 1,600 resources, which have almost tripled over the past decade, and 28,000 registered users. Two hundred and twenty medical faculty have contributed the resources; a majority of them were clinical cases and video clips, which accounted for 30% and 27% of all resources, respectively. The website has received increasing hits over the past decade; annual website hits increased from 80,000 in 2009 to over 300,000 in 2018. The number of hits on resources varied across resource types and subjects; 90% of all website hits were on online videos, and 28% of them originated from mobile devices. Among the online videos, those on procedural skills received more hits than those on patient encounters and video lectures. CONCLUSION: Our findings demonstrate the increasing use of e-learning in medical education in Korea over the past decade. Our study also shows a wide disparity in the frequency of use in learning resources across resource types and subjects, which have implications for improvements in the design and development of learning resources to better meet medical students’ curricular needs and their learning styles.

Do Korean Medical Schools Provide Adequate End-of-Life Care Education? A Nationwide Survey of the Republic of Korea's End-of-Life Care Curricula / 한국호스피스완화의료학회지

PURPOSE: Physician competency in end-of-life (EOL) care is becoming increasingly important. This study investigated the EOL care curricula in Korean medical schools.METHODS: Questionnaires were issued to the faculty members responsible for the EOL care curricula at each of the medical schools. These included questions on the structure and content of the curricula, teaching methods, and faculty members' attitudes to the curricula.RESULTS: Characteristics of the EOL care curricula were compiled from 27 (66%) of the 41 medical schools. All of the medical schools taught essential aspects of the EOL care curriculum either as a separate course or embedded within other medical education courses. The mean time spent on EOL care teaching was 10 hrs (range, 2~32 hrs). The most frequently taught topics were delivering bad news (100%) and symptom management (74%). When the palliative care education assessment tool (PEAT) was used to evaluate the curricula, a median of 11 PEAT objectives was met (range, 2~26; maximum, 83). More than two teaching methods were used in most of the curricula. However, lectures were the only teaching method used by three medical schools. 78% of faculty members who were responsible for curriculum reported dissatisfaction with it, whereas 18% believed that the time allotted to it was adequate. Only 7% of these faculty members believed that their students were adequately prepared to practice EOL care.CONCLUSION: There is a need to improve EOL care education in basic medical curricula and to take a more systematic approach to achieving learning outcomes.

Development of e-learning in medical education: 10 years’ experience of Korean medical schools / 한국의학교육

PURPOSE@#We aimed to explore medical students’ online learning patterns and needs by analyzing data obtained from an e-learning portal of Korean medical schools.@*METHODS@#Data were obtained from learning resources and registered users of the e-learning portal by the consortium of 36 Korean medical schools, e-MedEdu (

Enhancing students' active learning and self-efficacy using mobile technology in medical English classes / 한국의학교육

PURPOSE@#This study investigated student experiences of mobile technology in a medical English course using a free mobile classroom application, Socrative and its impact on student learning to help them achieve the competency expected in the course.@*METHODS@#Questionnaires were administered of year 2 medical students enrolled in a medical English course between 2016 and 2017 to investigate their experience in using Socrative. Learning outcomes were assessed by comparing students' academic performance with that of the 2015 cohort, who had taken the same course without using mobile technology, and also by measuring changes in their self-efficacy in English over time during the course.@*RESULTS@#This study found students' positive perceptions of and overall satisfaction with their experience in using mobile technology in the medical English course. There were no differences in the academic performance between the study cohort and the comparison group. The ratio of students who were in the remediation program after the mid-term examination was 11%, whereas the remediation ratio of the 2015 cohort was 21%. Students' self-efficacy in English improved significantly in the writing and reading domains (p < 0.05).@*CONCLUSION@#This study found several benefits of using Socrative in the medical English course. Socrative fostered the classroom interaction by encouraging input from every student and sharing it instantly with the whole class. There was also learning improvement with the use of Socrative. Furthermore, it has the potential to enhance assessment by offering more various forms of assessment than that of conventional audience response systems.

Enhancing students' active learning and self-efficacy using mobile technology in medical English classes / 한국의학교육

PURPOSE: This study investigated student experiences of mobile technology in a medical English course using a free mobile classroom application, Socrative and its impact on student learning to help them achieve the competency expected in the course. METHODS: Questionnaires were administered of year 2 medical students enrolled in a medical English course between 2016 and 2017 to investigate their experience in using Socrative. Learning outcomes were assessed by comparing students' academic performance with that of the 2015 cohort, who had taken the same course without using mobile technology, and also by measuring changes in their self-efficacy in English over time during the course. RESULTS: This study found students' positive perceptions of and overall satisfaction with their experience in using mobile technology in the medical English course. There were no differences in the academic performance between the study cohort and the comparison group. The ratio of students who were in the remediation program after the mid-term examination was 11%, whereas the remediation ratio of the 2015 cohort was 21%. Students' self-efficacy in English improved significantly in the writing and reading domains (p < 0.05). CONCLUSION: This study found several benefits of using Socrative in the medical English course. Socrative fostered the classroom interaction by encouraging input from every student and sharing it instantly with the whole class. There was also learning improvement with the use of Socrative. Furthermore, it has the potential to enhance assessment by offering more various forms of assessment than that of conventional audience response systems.

Doctors' Images Represented in the Korean Press: From a Perspective of the Korean Doctor's Role 2014 / 의학교육논단

This study examined doctors' images represented in the Korean press to identify overall public perceptions of doctors and to suggest areas for improvement to enhance their image. All news reports published in the two major Korean daily newspapers between years 2011 and 2015 related to doctors and the practice of medicine were searched and collected. The news reports were categorized into the five competency domains in the Korean doctor's role (i.e., patient care, communication and cooperation, social accountability, professionalism, and education and research). Each news item was coded as being either positive or negative and was given a score regarding the extent to which positive or negative image that it represents of doctors using the Doctor Image Scale (DIS) score. A total of 314 news reports were collected, a majority of which were on patient care (36%), professionalism (33%), and social accountability (23%). Positive stories slightly outnumbered negative ones (56% vs. 44%). The largest number of positive news reports was in patient care (n=82); negative news reports most frequently appeared in professionalism (n=99) and patient care (n=32). The total DIS score was also positive (+28): the highest positive DIS score was in social accountability (+164); the highest negative DIS score was obtained in professionalism (−226). This study revealed overall positive portrayals of doctors in the Korean press, yet doctors need to better comply with regulations and ethical guidelines and enhance their medical knowledge and clinical skills and to improve their image.

Survey on the undergraduate curriculum in clinical pharmacology and interns' prescribing ability in South Korea

Appropriate prescription writing is one of the critical medical processes affecting the quality of public health care. However, this is a complex task for newly qualified intern doctors because of its complex characteristics requiring sufficient knowledge of medications and principles of clinical pharmacology, skills of diagnosis and communication, and critical judgment. This study aims to gather data on the current status of undergraduate prescribing education in South Korea. Two surveys were administered in this study: survey A to 26 medical schools in South Korea to gather information on the status of undergraduate education in clinical pharmacology; and survey B to 244 intern doctors in large hospitals to gather their opinions regarding prescribing education and ability. In survey A, half of the responding institutions provided prescribing education via various formats of classes over two curriculums including lecture, applied practice, group discussions, computer-utilized training, and workshops. In survey B, we found that intern doctors have the least confidence when prescribing drugs for special patient populations, especially pregnant women. These intern doctors believed that a case-based practical training or group discussion class would be an effective approach to supplement their prescribing education concurrently or after the clerkship in medical schools or right before starting intern training with a core drug list. The results of the present study may help instructors in charge of prescribing education when communicating and cooperating with each other to improve undergraduate prescribing education and the quality of national medical care.

The Necessity for End-of-Life Care Education: A Preliminary Analysis with Interns at Two University Hospitals / 한국호스피스완화의료학회지

PURPOSE: This study was performed to explore the current state of end-of-life (EoL) care education provided to new interns at two university hospitals. METHODS: A questionnaire was given to incoming interns (N=64). The levels of acquired knowledge and experience of clinical observation were measured. Seven areas for self-assessment questions were identified and used to analyze the interns' attitudes towards EoL-related education and practice. RESULTS: On average, participants learned five elements (nine in total) from EoL-related classes and two (seven in total) from clinical observation. The most frequently educated element was how to deliver bad news (96.9%) in the classroom setting and how to control physical symptoms (56.5%) in clinical observation. Less than 20% received training on EoL care communication, including discussion of advanced directives. Compared with participants who had no EoL training, those who had EoL training showed positive attitudes in all seven categories regarding overall satisfaction, interest and preparedness in relation to EoL-care classes and practice. CONCLUSION: Although interns are responsible for caring of dying patients, their EoL training in classroom and clinical settings was very insufficient. Further research should be conducted to establish an education system that provides sufficient knowledge and training on EoL care.

Characteristics of medical teachers using student-centered teaching methods / 한국의학교육

PURPOSE: This study investigated characteristics of medical teachers who have adopted student-centered teaching methods into their teaching. METHODS: A 24-item questionnaire consisted of respondent backgrounds, his or her use of student-centered teaching methods, and awareness of the school's educational objectives and curricular principles was administered of faculty members at a private medical school in Korea. Descriptive statistics and chi-square analysis were conducted to compare faculty use of student-centered approaches across different backgrounds and awareness of curricular principles. RESULTS: Overall response rate was 70% (N=140/200), approximately 25% (n=34) of whom were using student-centered teaching methods. Distributions in the faculty use of student-centered teaching methods were significantly higher among basic sciences faculty (versus clinical sciences faculty), with teaching experiences of over 10 years (versus less than 10 years), and who were aware of the school's educational objectives and curricular principles. CONCLUSION: Our study indicates differences in medical faculty's practice of student-centered teaching across disciplines, teaching experiences, and their understanding of the school's educational objectives curricular principles. These findings have implications for faculty development and institutional support to better promote faculty use of student-centered teaching approaches.

The utility of multiple mini-interviews: experience of a medical school / 한국의학교육

PURPOSE: This paper aims to introduce the design of multiple mini-interviews (MMIs) as a tool to assess medical school applicants' attributes in alignment with the school's educational goals and to evaluate its utility. METHODS: In this MMI, candidates rotated through six stations (10 minutes per station), in which specific interview topics were drawn by mapping the school's educational goals with the core competencies for entering medical students. We conducted post-MMI surveys of all of the interviewers and candidates to investigate their experiences of MMIs. The G-coefficient and interclass correlation were analyzed to investigate the reliability of this test. Additionally, the candidates' MMI scores were compared across different backgrounds and a univariate analysis was used to estimate correlations between their MMI scores and prior academic achievements. RESULTS: A total of 164 candidates (a 98.8% response rate) and 19 interviewers (a 100% response rate) completed the surveys in the years 2014 and 2015. Both candidates and assessors showed positive responses to MMIs. The G-coefficient of MMI scores was 0.88 and the interclass correlation coefficients ranged from 0.58 to 0.75. The participants' total MMI scores did not differ across genders or undergraduate backgrounds and were not associated with age, undergraduate graduate point averages, nor the Korean medical school admission test (Medical Education Eligibility Test) scores. CONCLUSION: Our study illustrates the utility of MMIs that utilize the institution's educational goals to identify attributes to be pursued in the admission interviews in alignment with the institution's core values. Future research is warranted of the predictive validity of this MMI.

Ubiquitous testing using tablets: its impact on medical student perceptions of and engagement in learning / 한국의학교육

PURPOSE: Ubiquitous testing has the potential to affect medical education by enhancing the authenticity of the assessment using multimedia items. This study explored medical students' experience with ubiquitous testing and its impact on student learning. METHODS: A cohort (n=48) of third-year students at a medical school in South Korea participated in this study. The students were divided into two groups and were given different versions of 10 content-matched items: one in text version (the text group) and the other in multimedia version (the multimedia group). Multimedia items were delivered using tablets. Item response analyses were performed to compare item characteristics between the two versions. Additionally, focus group interviews were held to investigate the students' experiences of ubiquitous testing. RESULTS: The mean test score was significantly higher in the text group. Item difficulty and discrimination did not differ between text and multimedia items. The participants generally showed positive responses on ubiquitous testing. Still, they felt that the lectures that they had taken in preclinical years did not prepare them enough for this type of assessment and clinical encounters during clerkships were more helpful. To be better prepared, the participants felt that they needed to engage more actively in learning in clinical clerkships and have more access to multimedia learning resources. CONCLUSION: Ubiquitous testing can positively affect student learning by reinforcing the importance of being able to understand and apply knowledge in clinical contexts, which drives students to engage more actively in learning in clinical settings.

Integrating Problem-Based Learning into Clinical Clerkship: A Pilot Study / 한국의학교육

PURPOSE: This study aims to evaluate the effectiveness of a new teaching segment, named "problem-based clinical teaching," for the clinical clerkship in the undergraduate medical curriculum. METHODS: Students were given a problem weekly on a case that they had seen during their rotation. The problem was provided by the instructor from a case that had already been diagnosed but came up with an additional problem that called for further investigation by the attending physician. The task for the students was to conduct the investigation and discuss the problem with the attending physician. A survey was conducted of a class of 3rd year medical students (n=43) who completed clerkships in internal medicine to measure the level of student engagement in the problem-based clinical teaching segment and the students' overall perceptions of this new teaching method. RESULTS: Students generally agreed with the statements that they were actively engaged in the learning during the problem-based clinical teaching session. The students also perceived that this teaching session helped them acquire a deeper understanding of the knowledge and that it enhanced their problem solving skills and motivation. CONCLUSION: Problem-based clinical teaching is a useful educational method to apply problem-based learning in clinical clerkship settings.